Project Summary Unintentional poisoning is the second leading cause of injury death in the United States. Collaboration between poison control centers (PCCs) and emergency departments (EDs) is dependent upon verbal, telephone communication that can lead to miscommunication, data loss, and error. (3, 4). Recent research has identified numerous vulnerabilities and inefficiencies in the current telephone-based system of collaboration, vulnerabilities that must be addressed in order to ensure patient safety. Health information exchange (HIE), the electronic exchange of patient information, could better support PCC-ED collaboration for poisoned patients during routine operations and in disaster scenarios, when telephone-based communication is fragile. However, we currently lack both process models and informatics tools (standards and software) for PCC-ED health information exchange and this poses a substantial barrier to HIE for U.S. poison control centers operating with limited resources. Moreover, there is no available information on the clinical effects of implementing this type of provider-to-provider health information exchange, including effects on workflow and patient care. The specific aims of this study are as follows: (1) Develop a model process for HIE supported ED- PCC collaboration, (2) Develop and implement informatics tools for HIE supported ED-PCC collaboration, and (3) Evaluate the effects of the model HIE process and informatics tools on workflow, communication, efficiency, and utilization. We will develop a replicable, scalable process for ED-PCC health information exchange and develop informatics tools that enable emergency departments and poison control centers to engage in HIE. We will also evaluate the effect of the prototype information exchange process on workflow and clinical outcomes including emergency department door-to-decision time, time to PCC case closure, and change in the number of telephone calls exchanged between EDs and PCCs. These innovations reflect patient-focused information management and are designed to ensure availability of poisoning-related information to support transitions and collaborations in care. !